Healthcare Provider Details

I. General information

NPI: 1558752535
Provider Name (Legal Business Name): CHASIDY MCALLISTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 ROGERS AVE FL 3
FORT SMITH AR
72903-4067
US

IV. Provider business mailing address

PO BOX 776084
CHICAGO IL
60677-6084
US

V. Phone/Fax

Practice location:
  • Phone: 479-573-3042
  • Fax: 479-452-2924
Mailing address:
  • Phone: 479-573-3042
  • Fax: 479-452-2924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberA004316
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberA004316
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: